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Larissa Ramalho Dantas Varella Dutra,1 Rodrigo Pegado,2 Luana Karyne Silva,2 Hégila da Silva Dantas,2 Hialison Andrade Câmara,2 Edson Meneses Silva-Filho,2 Grasiéla Nascimento Correia,2 Maria Thereza Albuquerque Barbosa Cabral Micussi1 1Health Science Center, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil; 2Graduate Program in Rehabilitation Science, Federal University of Rio Grande do Norte, Rio Grande do Norte, BrazilCorrespondence: Edson Meneses Silva-FilhoFaculdade de Ciências da Saúde do Trairi - Universidade Federal do Rio Grande do Norte, FACISA/UFRN, Rua Teodorico Bezerra, Santa Cruz, RN 59200-000, BrazilTel +55 81 99470 6661Email meneses.edson@yahoo.com.brBackground: Primary dysmenorrhea is a common and often debilitating condition affecting 40– 90% of menstruating women. This condition reduces functionality, quality of life, and social activities. Transcranial direct current stimulation (tDCS) has been used in many chronic pain syndromes, with evidence of improved pain, functionality, and moodin women with primary dysmenorrhea.The objective of this study was to determine whether tDCS could offer clinical benefits on pain, anxiety, affectivity, and functionality in women with primary dysmenorrhea.Methods: This parallel, sham, randomized, double-blind trial was conducted with 26 women randomized into shamtDCS and activetDCS. Anodal tDCS was applied for 5 consecutive days over F3 corresponding to theleft dorsolateral prefrontal cortex (DLPFC) and thecathode electrode over Fp2 for 20min with an intensity of 2mA. A numeric rating scale(NRS) was used to assess pain, anxiety, positive and negative affect, and submaximal aerobic performance during two consecutive menstrual cycles.Results: No significant interaction was found between intervention and time on theNRS [F(2,44) = 1.358, p= 0.26], and asignificant main effect of time [F(2,44) = 4.446, p= 0.01] was found. The active group showed a significant reduction in anxiety (p= 0.03) with a mean difference of 5.12 (95% CI 0.79 to 11.05). No significant differences in positive and negative affect were found (p = 0.95 and p= 0.15, respectively). Submaximal aerobic performance was significantly greater in theactive group [F(2,21) = 5.591, p= 0.02], with a mean difference of 70.87 (95% CI 8.53 to 133.21).Conclusion: Anodal tDCS over theDLPFC seems to be an effective therapeutic approach for improving anxiety and functionality in women with primary dysmenorrhea.Keywords: non-invasive brain stimulation, menstrual cycle, pain, anxiety, functional capacity

Background Interstitial cystitis or painful bladder syndrome is a chronic disorder that presents an unknown etiology, with no generally accepted treatment. Although there is no gold standard treatment, transcranial direct current stimulation (tDCS) has shown efficacy in several chronic pain syndromes with decrease in pain, and improved functionality and mood. tDCS could be a safe, ease to use, and low-cost complementary intervention for patients with interstitial cystitis. Aim This study will investigate the effects of a tDCS protocol on pain, functionality, and mood in patients with interstitial cystitis. Methods A randomized controlled clinical trial with two arms. Women will be randomized into two groups: active or sham. Anodal tDCS over the primary motor cortex will be performed for 5 consecutive days with an intensity of 2 mA for 20 min. Participants will be evaluated five times: 1 week before intervention; on the 5th day of tDCS; and 1, 6, and 12 months after the last day of tDCS. The outcomes will be assessed using the numeric rating scale, McGill pain questionnaire, positive and negative affect scale, international consultation on incontinence questionnaire for female lower urinary tract symptoms, Hamilton anxiety scale, six-minute walk test, patient global impression of change, and voiding diary. Discussion Only the active group will be expected to show decreased pain. The results of this trial will be the first step in the use of neuromodulation in interstitial cystitis and will provide additional data to support new studies with tDCS.

Introdução: A mulher climatérica apresenta fraqueza muscular que pode gerar disfunções pélvicas. Aparentemente a prática regular de atividade física nesse período promove uma melhora da função muscular global. Objetivo: avaliar a função da musculatura do assoalho pélvico (MAP) de acordo com nível de atividade física em mulheres climatéricas. Métodos: estudo observacional, analítico e transversal. A amostra foi composta por 457 mulheres divididas de acordo com o nível de atividade física. A coleta de dados ocorreu através da aplicação da ficha de avaliação, aplicação do Questionário Internacional de Atividade Física (IPAQ), e avaliação por meio da palpação vaginal e manometria da MAP. Para análise estatística foram usados os testes de Kolmogorov-Smirnov, ANOVA, qui-quadrado e correlação de Pearson. Resultados: As mulheres classificadas como muito ativas obtiveram uma pressão média de 45,24cmH2O, as ativas apresentaram 29,03cmH2O e as sedentárias 27,20cmH2O, com diferença estatística entre os grupos (p=0,003). Conclusão: Quanto mais ativa for a mulher climatérica, melhor será a função da MAP.

BACKGROUND AND OBJECTIVES: Abdominal and pelvic pain is a prevalent condition among women in the immediate postpartum period. Non-pharmacological therapies are of great importance for the treatment of this condition since they do not cause systemic side effects, such as drowsiness, irritability, and changes in the composition of breast milk. This article aims to identify and evaluate the efficacy of non-pharmacological analgesic therapies used in the immediate puerperium in abdominal-pelvic pain. CONTENTS: Searches were carried out in the main databases from September to October 2017 using the following descriptors "treatment" AND "pain" AND "postpartum"; "Treatment" AND "pain" AND "postpartum" AND "analgesics" AND "non-pharmacological". Controlled and randomized clinical trials published between January 2007 and August 2017, in Portuguese, English, and Spanish were included. Of the 1737 studies found in the databases, 42 were selected by the title. According to the eligibility criteria, 13 studies were included. The total sample size of the studies ranged from 21 to 266. In the intervention groups, the sample ranged from 11 to 126 women who underwent cryotherapy, transcutaneous electrical stimulation, LASER, acupuncture and ear acupressure. CONCLUSION: Interventional practices such as transcutaneous electrical nervous stimulation and cryotherapy presented significant data relevant to the reduction of abdominal and pelvic pain. The techniques of acupuncture and ear acupressure still present inconclusive data. Despite the relief of perineal pain, laser therapy showed no statistically significant effect on pain relief when compared to the placebo group. RESUMO JUSTIFICATIVA E OBJETIVOS: Dor abdominal e pélvica são condições prevalentes entre as puérperas no período pós-parto. As terapias não farmacológicas nesses casos são de grande importância, tendo em vista a ausência de efeitos adversos sistêmicos, tais como sonolência, irritabilidade e modificações no leite materno. O objetivo deste estudo foi identificar e avaliar a eficácia das terapias analgésicas não farmacológicas utilizadas no puerpério imediato na dor abdominal e pélvica. CONTEÚDO: Realizou-se buscas nas principais bases de dados, no período de setembro a outubro de 2017, utilizando-se as combinações: "treatment" AND "pain" AND "postpartum"; "treatment" AND "pain" AND "postpartum" AND "analgesics" AND "non-pharmacological". Foram incluídos ensaios clínicos controlados e randomizados, publicados no período de janeiro de 2007 a agosto de 2017, nos idiomas português, inglês e espanhol. Dos 1.737 estudos encontrados nas bases de dados, 42 foram selecionados pelo título. De acordo com os critérios de elegibilidade, incluiu-se 13 estudos. O tamanho total das amostras dos estudos variou entre 21 e 266. Nos grupos com intervenção, a amostra variou entre 11 e 126 mulheres que foram submetidas a crioterapia, estimulação elétrica nervosa transcutânea, LASER, acupuntura e auriculoterapia. CONCLUSÃO: As práticas intervencionistas como a eletroestimulação elétrica nervosa transcutânea e a crioterapia apresentaram dados significativos relevantes na redução da dor abdominal e pélvica. As técnicas de acupuntura e auriculoterapia ainda apresentam dados inconclusivos. Apesar de provocar alívio da dor perineal, a laserterapia não mostrou efeito estatisticamente significativo para alívio da dor quando comparada com o grupo placebo.

A fibromialgia (FM) é uma doença reumática, de etiologia desconhecida que apresenta como principal característica a dor musculoesquelética, desencadeando um ciclo de descondicionamento. A fisioterapia exerce um papel muito importante com os programas de exercícios físicos, compostos por alongamento, exercício aeróbio e exercício resistido para reverter os sintomas apresentados. Recentemente, estudos têm apontado para o fato de que os exercícios resistidos poderiam ocasionar uma redução da dor em pacientes com FM, gerando um novo questionamento sobre os efeitos do exercício resistido nestes pacientes. Com isso, este estudo teve o objetivo de investigar o efeito do treinamento resistido na redução dor em mulheres com fibromialgia. Para tanto, foi realizado uma revisão de forma sistematizada dos estudos publicados até maio de 2016 nas bases de dados eletrônicas PubMed, PEDro, Scielo e Lilacs. O levantamento dos estudos encontrados foi realizado no período de maio a junho de 2016, usando os seguintes descritores na língua inglesa: Physical Therapy Modalities, strength training, Pain, Fibromyalgia e seus equivalentes na língua portuguesa e espanhola. Após a busca, foram encontrados 85 artigos. Após a análise dos resumos, 80 artigos foram excluídos de acordo com os critérios pré-estabelecidos, restando apenas 5 estudos randomizados controlados, sendo selecionados para análise dos seus dados. Após a análise, conclui-se que o treinamento resistido reduz a dor em mulheres com fibromialgia, a partir da 8ª semana de treinamento, desde que esse seja realizado de forma continuada e orientada, com duração de no mínimo 30 minutos, com frequência de 2 a 3 vezes por semana.

[Purpose] To assess lower urinary tract symptoms in different stages of menopause and the quality of life of females with incontinence. [Subjects and Methods] The sample consisted of 302 females, aged between 40 and 56 years, divided into three groups: PRE (n= 81), PERI (n= 108) and POST (n= 113). This was a cross-sectional, analytical, observational study. Data were collected by assessment chart and conducting the International Consultation on Incontinence Questionnaire-Short Form. [Results] Most of the women had less than 10 years of schooling and were married. In PERI and POST menopause, the most frequent lower urinary tract symptoms were urinary urgency and stress incontinence. The PRE group did not exhibit nocturia, urge incontinence or urinary urgency, and had the lowest symptoms frequency. In the three stages, stress incontinence was the most prevalent symptom. Of the three menopause stages, PERI had a greater impact on urinary incontinence according to the International Consultation on Incontinence Questionnaire. [Conclusion] The presence of lower urinary tract symptoms can vary across the different stages of menopause and the urinary incontinence was the most frequent complaint. Moreover, it was observed that quality of life was more affected in the perimenopause stage.

Aims To evaluate the electrical activity of the pelvic floor muscles (PFM) in women with polycystic ovary syndrome. Methods Forty-two women with polycystic ovary syndrome (PCOS group) and 13 premenopausal women (control group) were recruited in this cross-sectional study. Total testosterone and estradiol were measured and muscle tone and maximum voluntary contraction (MVC) of PFM were determined by surface electromyography. Results There was a difference in muscle tone (PCOS = 59.9 µV and Control group = 25.5 µV; P

Maria Clara Eugênia de Oliveira,Larissa Ramalho Dantas Varella,Priscylla Helouyse melo Angelo,Maria Thereza Albuquerque Barbosa Cabral Micussi Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil Purpose: The aim of the study is to evaluate the pressure of the pelvic floor muscles (PFM) according to waist circumference (WC) and correlate the presence of urinary tract symptoms (UTS) with WC. Patients and methods: The study was observational and cross-sectional. One-hundred and sixty-four females between 45 and 65 years of age were evaluated. The sample was divided into two groups, according to WC: Group ≤80 (G≤80) was composed of females in whom WC was up to 80cm; and Group >80 (G>80) was composed of females with WC above 80cm. The subjects were assessed in terms of sociodemographic data, pre-existing conditions, urogynecological and obstetric history, and the presence of lower UTS (LUTS), as well as physical examination, measurement of WC, height, and weight. The PFM assessment was made by perineometry. To compare the mean between groups, the independent samples t-test was applied, and to correlate the WC with perineometry and LUTS, the Pearson’s correlation test was used. Results: The final sample was composed of 156 patients. The average age of participants was 55.21 (±24.5) years in G≤80 and 57.23 (±6.12) years in G>80. There were significant differences regarding the presence of LUTS between the groups (P80. There was a correlation between the presence of urinary urgency (r=0.7; P=0.00), nocturia (r=0.7; P=0.00), and urinary incontinence (r=0.9; P=0.00) with WC. Conclusion: Females with larger abdominal diameter have a higher prevalence of LUTS such as urinary incontinence, nocturia, and urinary urgency, as well as a lower PFM pressure. Furthermore, a relationship between LUTS with WC was also observed. Keywords: abdominal obesity, pelvic floor, urinary incontinence, females